Cranial Anchored Mandible Distraction Osteogenesis

Multiple or large distance mandibular distraction osteogenesis (MDO) in the older child is often complicated by iatrogenic temporomandibular joint (TMJ) pathology. The transmission of significant force to the TMJ in these particular patients is due to the greater distance of distraction required and the relative inelasticity of the soft tissue envelope. The authors present a clinical report of a successful asymmetrically vectored large distance MDO in a 13-year-old female with bilateral craniofacial microsomia with Goldenhar syndrome. During distraction, the TMJ joints were effectively unloaded from the forces of distraction using external bilateral cranial anchored devices (Cranio-Mandibular Fixator; KLS Martin, Jacksonville, FL). Angle's occlusion, facial angle, and evidence of TMJ pathology were assessed. Address correspondence and reprint requests to Edward P. Buchanan, MD, Division of Plastic Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin, Suite 610.00, Houston, TX 77030; E-mail: ebuchana@bcm.edu. Received 2 October, 2018 Accepted 31 October, 2018 The authors report no conflicts of interest. © 2019 by Mutaz B. Habal, MD.

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